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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 7 (1992), S. 165-170 
    ISSN: 1437-9813
    Keywords: Crohn's disease ; Childhood ; Bowel resection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract During the years 1979–1988, 63 children (38 male: 25 female) were first diagnosed as having Crohn's disease on the basis of histological findings. Twenty-nine per cent were less than 10 years old at the onset of symptoms; 40% of these cases took more than 1 year to diagnose. Most patients (59%) presented with abdominal pain and diarrhoea, but 40% presented with: a non-specific illness (14%); upper gastro-intestinal tract symptoms (14%); growth failure (6%); systemic disease (5%), or peri-anal disease (1%). There were signs of abdominal tenderness, distension, or an abdominal mass in over 50% of cases. Peri-anal Crohn's disease was present in 41% and a height less than the 10th centile was recorded at diagnosis in 45%. Children were treated with a combination of prednisolone and sulphasalazine. In 16 cases a bowel resection was performed. Surgery was indicated for localised stricture formation causing obstruction and for persistence of severe disease poorly responsive to steroids, particularly in the prepubertal child with growth failure. The extent and distribution of disease influenced outcome. Twenty-four of 39 children followed for more than 3 years are either well-controlled or disease-free at present.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-198X
    Keywords: Growth hormone ; End-stage renal disease ; Dialysis ; Transplant
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The minimal effective dose of growth hormone (GH) to promote growth in children on dialysis or following renal transplantation remains unsettled. In order to study the issue, “low-dose” GH was administered to children with end-stage renal disease (ESRD) receiving chronic automated peritoneal dialysis (APD,n = 6, 4 males, 2 females) or following renal transplantation (T,n = 9, 8 males, 1 female). No APD patient was GH deficient, while 1 T patient (no. 2) had data consistent with GH deficiency, although he was obese (body mass index = 34 kg/m2). The mean dose of GH after 6 and 12 months of treatment was 0.16±0.02 and 0.22±0.07 versus 0.16±0.03 and 0.27±0.21 mg/kg per week for APD and T patients, respectively. When analyzing all patients, there were no significant differences before or after 6 and 12 months of GH therapy within or between the two groups, in terms of height velocity, bone age, renal function (in the T group) and height Z-scores (Z-Ht). However, the height velocity Z-score (Z-HV) increased significantly at 6 and 12 months compared with baseline in the APD patients only (P 〈 0.05). When the 2 T patients with the most impaired renal function were excluded from the analysis, Z-HV also increased significantly in the T patients after 12 months of GH (P 〈 0.02). We conclude that following “low-dose” GH therapy, children with ESRD treated with APD or T have similar increases in HV, allowing maintenance of Z-Ht but not “catch-up” growth.
    Type of Medium: Electronic Resource
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